Your Right to Know

Enlarge ImageRequest to buy this photoBrooke LaValley | DispatchMary Riley of Portsmouth waves a bandana in support of the Medicaid expansion at a Statehouse rally. A poll taken last month found 62 percent of Ohioans favored the expansion.

In a historic rebuke, Gov. John Kasich got rolled by his own party this week, victimized by a
tea party-inspired evisceration of his plan to expand Medicaid coverage despite his passionate
pleas that the lives of Ohio’s neediest residents hang in the balance.

By saying no to broadening Medicaid’s reach, House Republicans turned against groups that
historically have been their political allies and campaign contributors, including the Ohio
Hospital Association, the Ohio Chamber of Commerce, Ohio Right to Life, major health insurers and
other influential groups supporting the expansion.

Instead, House Republicans stripped Kasich’s two-year budget of Medicaid services for 275,000
more Ohio adults without health-care coverage, which were to be paid for by $13 billion in federal
aid over seven years. That would have saved state taxpayers $400 million over the next two
years.

Longtime Statehouse observers said they can’t remember anything like it.

“I’ve never seen a governor, particularly when he has both branches of the legislature and that
much support from these kinds of groups, not get what he wants,” said Terry Fleming, who has
lobbied at the Statehouse for 33 years, now as an independent.

While tea party groups claimed credit for killing the Medicaid expansion allowed under the
federal Affordable Care Act, others said it failed because of an ingrained hatred of Obamacare
across GOP constituencies.

“I don’t think the interest groups backing the expansion understood how the label Obamacare
resonates with Republican voters,” said an independent lobbyist with health-care clients who spoke
only on condition of anonymity. “To them, Obamacare is like abortion. For Republicans, this isn’t a
policy issue, it’s a core philosophical belief.”

Political observers say Kasich might have hurt his case for Medicaid expansion when he and Lt.
Gov. Mary Taylor joined efforts by Republican Mitt Romney’s presidential campaign last year to
demonize Obamacare.

“When folks’ minds get so entrenched in their own ideology, we sometimes fail to see the wisdom
of others,” said Carolyn Givens, executive director of the Ohio Suicide Prevention foundation,
which supports the expansion.

“It’s an ideological aversion to Obamacare,” said Timothy Maglione, lobbyist for the Ohio State
Medical Association, which represents doctors and other health-care professionals and supports the
Medicaid expansion.

“Otherwise, (Medicaid expansion) clearly makes economic sense for the state. It clearly makes
sense for a healthier population for the state.”

Kasich’s effort also was hindered because the top two GOP legislative leaders, House Speaker
William G. Batchelder of Medina and Senate President Keith Faber of Celina, declined to express
public support for the expansion. Batchelder did not press his members to back the governor.

In an era of safely gerrymandered legislative districts and eight-year term limits, observers
said, legislative leaders have less ability to enforce discipline in their caucuses, even when
influential lobbies get behind an issue.

“I think term limits have a lot to do with why these powerful groups no longer can seem to beat
the tea parties or the ideologues on these issues,” Fleming said.

Despite the objections from his party, Kasich appeared to have significant public support for
the Medicaid expansion, as evidenced by a boisterous Statehouse rally yesterday of more than 2,000
people — the largest since demonstrations against Senate Bill 5 two years ago — who displayed
placards and buttons urging lawmakers to “put people above politics.” A poll for
The Dispatch last month by Saperstein Associates found 62 percent of Ohioans favored the
expansion, with 29 percent opposed.

Mark Davis, president of the Ohio Provider Resource Association, said during the rally that
opposition to the expansion is rooted in “partisan politics from folks angry about losing the last
election” and getting prepared for next year’s primaries.

“This makes good business sense, good sense for the state and for people (in need of health
care),” Davis said. “This is federal money (that) if we don’t use will go somewhere else.”

Susan Bennett, 52, of Columbus, said she used to look down on those on government assistance
when she was a well-off, stay-at-home mother in Westerville. But after her husband lost his
business and the couple lost their home and, ultimately, their marriage, her opinion changed.

Uninsured, Bennett now works low-wage temporary jobs and cannot afford treatment for skin cancer
on her face and hand.

“It causes a lot of anxiety every time I look in the mirror. Will I be able to get treatment
before they have to remove half of my lip?”

The fight against the Medicaid expansion has emboldened tea party groups that take credit for
killing it. They threaten to mount primary-election opposition to any GOP lawmaker supporting the
expansion.

Chris Littleton, a founder of the tea party group Ohio Rising, said polling and focus groups
show the Medicaid expansion is wildly unpopular with GOP voters. That tide is powerful enough to
defeat even entrenched Republicans, he said.

“We know that in some instances more than 70 percent of Republican primary voters dislike not
just Medicaid expansion, but if you match it with Obamacare expansion, it’s an astronomical number
of voters,” said Littleton, who has produced Web videos and mailers castigating Kasich.

Backers of Medicaid expansion have not given up the fight but are coming to realize that they
must change tactics to counter the tea party threats.

As the House-revised budget moves to the Senate, hospitals and other Medicaid expansion
advocates, including the powerful AARP Ohio, said they will mount a more aggressive campaign to
change the minds of recalcitrant GOP lawmakers.

The AARP said it will make voters aware of which legislators opposed the expansion.

Even though Democratic lawmakers overwhelmingly support Medicaid expansion, most were not
expected to vote for Kasich’s budget even with the expansion.

Bill Sundermeyer, AARP’s associate state director, said both political parties deserve blame for
the Medicaid mess.

“To justify opposition on the basis that it carries the label of a president you disagree with,
and likewise, for the (Democratic) party to use this issue to posture for an upcoming election, is
inappropriate,” he said. “It needs to stop immediately. We have people suffering and, quite
frankly, we have some who will not live through this debate.”